Provider Demographics
NPI:1548337298
Name:OB GYN SPECIALISTS OF ALABAMA, P.C.
Entity type:Organization
Organization Name:OB GYN SPECIALISTS OF ALABAMA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAIN
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCLAURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-384-0011
Mailing Address - Street 1:3400 HIGHWAY 78 E
Mailing Address - Street 2:SUITE 510
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-8907
Mailing Address - Country:US
Mailing Address - Phone:205-384-0011
Mailing Address - Fax:205-384-4538
Practice Address - Street 1:3400 HIGHWAY 78 E
Practice Address - Street 2:SUITE 510
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-8907
Practice Address - Country:US
Practice Address - Phone:205-384-0011
Practice Address - Fax:205-384-4538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL15097305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization